Association for Behavior Analysis International

Restrictive and repetitive patterns of behavior can be observed in many children with autism through their food selections which may then evolve to feeding difficulties. Food refusal, food selectivity, and refusal to self-feed are three common categories of feeding problems in children with autism. Often times escape extinction is the intervention used to help minimize the feeding problems however this is not always feasible for implementation due to challenging interfering mealtime behaviors and parent concerns with the procedure. Interventions for increasing novel food acceptance without the use of escape extinction or other invasive procedures are important to analyze for implementation of least invasive procedures. Observational learning was implemented to increase novel food consumption and its effectiveness was demonstrated as evident from the participants’ flexible responding. Increasing self-feeding is also vital for health, and therefore, educational outcomes. The use of access to motor stereotypy as reinforcement for increasing rate of meal consumption is also examined.

Graduate students of Applied Behavior Analysis and practitioners

Restrictive patterns of behavior can be seen in many children with autism in their food selections which results in feeding problems. The three main categories of feeding problems observed in children with autism are food refusal, refusal to self-feed, and food selectivity. Interventions that prevent the child’s ability to escape from the food presented has demonstrated an increase in the children’s food acceptance but are difficult for caregivers to successfully implement away from the treatment team. This literature review includes 20 articles with 28 total participants that implemented feeding interventions without the use of escape extinction or punishment procedures have been implemented to increase food acceptance. Each article was analyzed across several dimensions (participants, setting, assessments conducted, experimental design, intervention implemented, and outcome and generalization). From this analysis, information regarding the use of positive practices for feeding intervention is discussed as well as limitations in current literature and suggestions for future research and clinicians.

Research addressing food selectivity has involved intrusive techniques such as escape extinction. It is possible that observational learning methods employed in previous studies could provide the desired results with respect to food selectivity without the need for invasive physical interventions. The purpose of this study was to evaluate the effectiveness of an observational learning procedure on the selection of food items of three children diagnosed with autism spectrum disorder. Baseline consisted of a simple task after which a choice was presented between high- and low-preferred foods. The intervention consisted of observing an adult engage in the same task and selecting the low-preferred food while making favorable comments and engaging with the food in novel ways. The results of a reversal design demonstrated that selection of the low-preferred food only occurred following the introduction of the intervention, and all three participants engaged in flexible responding as a result of the intervention.